Assessor’s justification guide: Care/finance need (copy paste for your cases)
View the recommendation guide below :
This guide sets out when and how Brain in Hand can be recommended. It outlines how Brain in Hand meets eligible needs under the Care Act 2014, supports independence in everyday tasks and helps prevent difficulties from escalating for people who experience anxiety, cognitive processing difficulties, or challenges with emotional regulation.
The guide shows how Brain in Hand can reduce reliance on informal support, help maintain wellbeing, and prevent escalation to more intensive services. It also sets out circumstances where a joint funding approach between Adult Social Care and the NHS may be appropriate.
| Comprehensive recommendation |
[NAME] experiences cognitive processing difficulties and heightened anxiety which significantly affect their ability to initiate tasks, sequence activities, and regulate emotional responses. When overwhelmed, they become unable to make decisions or complete daily routines without prompting. Due to difficulties with task initiation and emotional regulation, [NAME] is unable to reliably maintain personal hygiene, prepare meals, or attend appointments without support. This impacts multiple Care Act outcomes, including maintaining personal hygiene, managing nutrition, and accessing necessary services. When unsupported, [NAME] experiences heightened distress which can result in withdrawal, missed meals, disrupted sleep, and periods of low mood. This has a significant impact on emotional wellbeing, sense of control, and ability to live independently. Brain in Hand is an assistive digital self-management support service that combines a personalised app with structured human support. It is designed to help individuals manage anxiety, initiate tasks, and follow daily routines independently. Through the app, [NAME] receives structured prompts, reassurance messaging, and step-by-step guidance to support daily activities such as personal care, meal preparation, and attending appointments. These supports reduce reliance on memory and decision-making during periods of anxiety or cognitive overload, enabling tasks to be completed more consistently. When [NAME] becomes overwhelmed or unable to progress with tasks, Brain in Hand provides access to on-demand support, offering immediate guidance and reassurance to help regulate emotional responses and return to activities without requiring direct intervention from carers or family members. Without this assistive technology, [NAME] requires frequent reassurance and prompting from informal carers to manage daily living tasks. This level of support is currently unsustainable and presents a risk of carer strain or breakdown. Brain in Hand represents the least restrictive intervention by enabling [NAME] to self-manage anxiety and structure their day independently, reducing reliance on regular in-person support while maintaining safety and wellbeing. Provision of Brain in Hand is expected to prevent deterioration in mental wellbeing, reduce periods of distress and withdrawal, and minimise the likelihood of crisis escalation or unplanned service involvement. The cost of Brain in Hand is proportionate when compared with ongoing domiciliary care, repeated crisis interventions, or increased reliance on family support. It provides a preventative and cost-effective means of meeting eligible needs while supporting independence. In accordance with the Care Act 2014, [NAME] has eligible needs arising from cognitive processing and emotional regulation difficulties which have a significant impact on wellbeing and ability to achieve key outcomes. Provision of Brain in Hand is a necessary and proportionate intervention to meet these needs, support identified outcomes and maintain independence while preventing escalation of care requirements.
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| Recommendation for joint funding |
While [NAME] has identified health conditions and experiences symptoms that impact emotional wellbeing, assessment indicates that their primary needs relate to daily living, task initiation, emotional regulation, and maintaining independence rather than the provision of ongoing clinical or nursing care. These needs fall within the scope of the Care Act 2014. It is recognised that Brain in Hand, as an assistive digital self-management support service, may also contribute to improved mental wellbeing by reducing distress, supporting emotional regulation, and decreasing reliance on crisis or reactive health interventions. On this basis, a joint funding approach between Adult Social Care and the NHS would be appropriate, reflecting shared preventative benefits and supporting integrated working in line with national guidance.
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Recommendation for joint funding - short version |
[NAME]’s primary needs relate to daily living, task initiation, and maintaining independence and therefore fall within the scope of the Care Act 2014. Brain in Hand, as an assistive self-management support service, also offers preventative mental health benefits; a joint funding approach is therefore appropriate to reflect shared outcomes across health and social care. |